At first glance, U=U may look to some like a complex math equation. But it’s meaning isn’t complicated in the slightest, especially for people living with HIV.
U=U is shorthand for “Undetectable = Untransmittable.” That means if someone living with HIV is on the appropriate medications and has a consistently undetectable level of the virus in their blood when tested, they cannot transmit HIV to their sexual partner(s).
“[Being undetectable] freed me,” says Murray Penner, 59, a D.C.-based HIV advocate and U.S. Executive Director at the Prevention Access Campaign. “…even when I was being ‘safe with sex’ before U=U, I always had this fear that I was going to transmit HIV to my partners. And now I no longer have to worry about that.”
His initial worry comes from a place of truth: sexual activity has long been the leading method of HIV transmission, particularly among gay and bisexual men. Yet, the relief that he felt when he became undetectable also speaks to the truth and importance of campaigns like U=U and the need for more thoughtful, holistic approaches to educating others.
“A lot of people don’t understand [HIV],” Penner says. “They don’t understand that people living with HIV can live a long and normal life.”
Penner, who tested positive for HIV in 1986, has seen and felt firsthand the stigma that comes with living with the virus. But he’s hopeful U=U (often stylized as #UequalsU) can free others as it did himself.
“[U=U] is a real game-changer,” Penner says. “It has so much potential to change not only the way people live with HIV, but change the face of HIV and what it looks like to society.”
In the height of the HIV/AIDS epidemic in the 1980s, medical and societal knowledge around the virus was severely limited, and, at times, it was nothing more than fear-mongering, painful homophobia and biphobia and harmful misinformation.
While some of those feelings still exist today, science is getting better.
Prevention methods like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are more prevalent than ever, and treatment has transformed through advancements in antiretroviral drugs. In D.C. alone, the number of new HIV cases in D.C. has decreased by roughly 49 percent from 2011 to 2018 … and a remarkable 73 percent since 2007.
For Derrick “Strawberry” Cox, 31, this all starts in one place: the doctor’s office.
“I express and encourage people to really have that strong relationship with a doctor,” Cox, a lifelong D.C. resident who is heavily involved in D.C.’s health advocacy spaces. “If you don’t feel comfortable with [your] doctor … get someone that you can talk to literally about anything.”
An open relationship with a healthcare provider, as Cox mentions, is crucial for those living with HIV. Consistent treatment and testing are integral parts of both becoming and maintaining one’s undetectable status — and, in turn, preventing transmission between partners.
Cox, who himself is undetectable, speaks with those who are newly diagnosed at a support group through Whitman-Walker Health. More than anything, he says he encounters people who are still coming to terms with their new reality.
“[Many] don’t want to accept the fact that they are HIV-positive,” Cox adds. “Most of them don’t want to take the pills, and most of them feel, you know, disgusting or dirty. [Stigma] is still a huge thing even though we’ve come a long way.”
Both Cox and Penner are rightfully adamant in saying there is nothing “dirty” about having HIV and look ahead to a future where people living with HIV — undetectable or not — are seen simply for who they are: human beings.
“HIV doesn’t define a person,” Penner says. “I’m a person just like you’re a person and just like somebody else next to me as a person. Don’t let HIV define you [or others].”
For more important information on U=U or if you’re looking for HIV-related testing (some are available at home due to COVID-19) and treatment options in D.C., visit sexualbeing.org. A number of critical resources are available at no cost that can help you find a doctor, support group, or the treatment you need.